lindsay's journey

Lindsay started to get requests to take elective undergrad students who are looking for experience in rural family medicine. Over the following 3 years, Lindsay had a student for one or two weeks on an annual basis. Each time, she oriented the students to her practice, and they spent 2-4 weeks with her everyday. The learners were keen, curious and professional. Sometimes Lindsay taught the students about techniques in history taking and physical exams. Other times she guided them in performing minor procedures. Lindsay also works as a hospitalist on some weekends at the local hospital. She finds this work a bit more stressful; even though there are many teaching opportunities, Lindsay wonders whether she could incorporate teaching activities on these hectic shifts. Overall, Lindsay enjoys working with the students, but she wonders about how to improve her teaching skills.

Lindsay feels good about her interaction with learners. She gets along well with most and finds teaching satisfying. However, she often wonders how she measured up to other teachers. Lindsay understands that her learners do complete learner evaluations of teaching but a number of them needs to be collected before she can access them. Two years later, Lindsay received an email from her department and found a link to TES (Teaching Effectiveness Score). She read through them and found some very high scores. “Very knowledgeable, able to identify knowledge gaps and address them effectively.” She also found a couple of comments like this: “appeared to be rushed; did not have time to directly observe me taking a history”.

Today Lindsay receives an email from the office of faculty appointments. It invites her to renew her appointment. She opens the attachment and finds that her contribution hours to date were just sufficient for the same level of appointment (ACP, adjunct). She opens the renewal form and starts to fill in the blanks. She reads the question: “which faculty development events have you attended in the last 3 years, e.g. CCME”. “What is CCME?” Lindsay wondered.

She wonders whether her appointment would be in jeopardy as she has attended only one event. The next question is about which topics in faculty development would she have an interest in attending. Lindsay thought of a few topics, like how to give feedback, how to teach in a busy clinical environment, and then realized that some of these topics were already presented and she couldn’t attend. Lindsay realizes that she has a problem. She has identified some learning needs; there are resources available to address them, but she can’t seem to access them.

mid-career

Fast-forward 10 years, Lindsay’s practice has evolved. She remains a busy office-based family physician and continues to look after patients at the retirement home. She had successfully renewed her part-time faculty appointment twice. One of her teaching colleagues retired, and she applied to become a residency primary preceptor. She now supervises a resident in family medicine most months of the year. The experience was a lot more work than she had imagined but also very rewarding.

With a resident, she finds that her clinical workload is reduced, while her teaching/mentoring responsibility has increased substantially. This was a welcome change for her. As she became more comfortable in her clinical practice and teaching, she was afforded more opportunities to reflect on her interests in education and her own continuing professional development. She has paid more attention to the university’s offerings of resources and activities and over time, became more familiar with the emails. She keeps a chat group of other residency primary preceptors on her phone to exchange ideas, share updates on the residency program. She developed a strong friendship with the other resident preceptor at her practice location, and started to attend workshops together. Contrary to her earlier experience, Lindsay feels well connected into the community of practice.

She finds that she gravitates towards workshops and resources that targeted what she considers “non-technical skills”, or skills requisite of the CanMEDS-FM “intrinsic expert roles”. In particular, she feels that learning activities that help her improve on communication and leadership skills can have broad application in her work. She appreciates that these learning activities are often low cost, and sometimes accredited for Mainpro+, the College of Family Physicians’ CPD program certification. In addition to these benefits, Lindsay has really enjoyed the opportunities to network with colleagues at these events, whom she would otherwise rarely see. After being a faculty member for 10+ years, Lindsay feels that her university appointment as a part time clinical faculty member has paid off.

While enjoying her practice, teaching and learning, Lindsay ponders about the next steps in her career. As she turned 40, Lindsay experiences some mid-life and mid-career musings. Her financial advisor has highlighted that she is well-situated regarding her children’s RESPs and her own RRSPs. As her children gain independence, she finds herself free a couple of evenings a week that she could allocate to additional learning or projects. Lindsay mulls over her options and reviews several options. Should she develop herself as a local leader in education? Could she put herself forward as a candidate for the boards of her provincial college? Would she focus her practice to develop a specific clinical expertise like addiction medicine or sports and exercise medicine? Lindsay wonders about what might energize the second half of her career. She even thinks about retirement from time to time, and wonders what her legacy should be.

late career

Lindsay turned 50 this year. Her children have moved to universities, and her clinical and teaching practices have matured. In the preceding decade, Lindsay committed her non-clinical time to developing expertise as a teacher. As she gained experience and skills, she became one of the most sought after preceptors in her program. She won a number of teaching awards as a result. With increased confidence, Lindsay put herself forward for the role of site director of the family medicine post-graduate program in Brantford. She soon realized the skills requisite to being a program leader are rather different compared to being a clinical preceptor. This year marks the end of her first term in this role and she will likely be renewed for a second term. Although she has had some challenging residents in her tenure, she succeeded in supporting the faculty preceptors in coaching them through residency.

Lindsay feels comfortable in the routine tasks of her current leadership role and enjoys working with her team. She still carries a full complement of patients, supervises 2 residents at any given time in addition to her administrative duties. Inadvertently, Lindsay discovered that she enjoys crafting a good presentation. When she created and gave a presentation on communication skills and leadership skills to her residents, her colleagues requested that she delivered the same presentation to groups of practicing physicians. Lindsay now has developed and perfected a series of talks on this topic, and become an invited speaker throughout all the McMaster campuses. This year, she is a featured guest speaker at McMaster University’s Annual Day in Faculty Development, and will be interviewed by the Podcast team from the Department of Family Medicine. Lindsay has found a part of her work that truly integrates her skills, her interests and her creativity. Lindsay looks forward to the best years of her career and thinks about retirement with mixed emotions. She envisions that she would reduce patient care responsibilities over time but she wants to continue to supervise residents, mentor colleagues, and stay engaged in faculty development as long as possible. “What do I still need to do? How do I know when it’s time to go?” She wonders.